Provider Demographics
NPI:1154066835
Name:LOCKWOOD, ADAM (PHD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:LOCKWOOD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1314
Mailing Address - Country:US
Mailing Address - Phone:707-298-1804
Mailing Address - Fax:
Practice Address - Street 1:899 FROST RD
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-4355
Practice Address - Country:US
Practice Address - Phone:330-963-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2723103T00000X
OHP.08276103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist